Healthcare Compliance and Finance

Filled under: Healthcare Compliance on October 2010

The Deficit Reduction Act of 2005 that was passed included stipulations on how to reduce the hemorrhaging medical service subsidizations that the federal government offers to more and more people each year. This was done so as to help reduce the overall outflow of money from the system and to increase the viability of the Medicare/Medicaid system for generations to come. However, it also put new regulations on the providers that offer services to the people who need to use these programs.

On the compliance side of things, there are many new rules and stricter punishments for everything from mistakes in the billing and processing of patients and especially if the error was intentional. Because of this there are now independent contractors that will review and locate errors in the documents that have been turned over to the Centers for Medicare and Medicaid Services. These contractors will then decide if there was an error and if so they will audit the claims that are made by that particular provider or facility and further educate them so as to avoid future mishaps.

Financially, this means that ever provider that offers services that are funded (wholly or partially) by the federal government must take extra care to avoid the ramifications that could be anything from a fine to jail time. While putting strain on the providers and facilities, it has alleviated some of the strain that has been put on the system in order to pay for fraudulent or wasteful claims.

1 Star2 Stars3 Stars4 Stars5 Stars (No Ratings Yet)